Field of the Invention
The present invention relates generally to portable/unattended sleep study monitoring, recording, and overnight oximetery testing, and more specifically to securing a sensor (such as an oximetry/oxygen saturation sensor) to an individual for purposes of conducting a sleep study with test fraud mitigation by virtue of preventing “test switching” between patients.
Description of the Related Art
Sleep apnea is a disorder affecting many individuals, and the disorder can have various adverse consequences, including death in the most extreme circumstances. One area where sleep apnea is of particular concern is when persons are performing “risk sensitive” job activities, such as operating dangerous machinery, driving vehicles on public roads, public transportation, security, military and medical jobs, and mining and oil work.
A driver impairment study directed by Doctor's Nelson Powell and Robert Riley was conducted at the General Motors proving grounds. The study results were published in Laryngoscope 111: May 2001, in a paper titled—‘The Road to Danger—The Comparative Risks of Driving While Sleepy’. The Powell and Riley study revealed that eleven measured reaction time metrics for various individuals showed that sleepy drivers were the same as the alcohol-challenged drivers when operating a car and attempting to avoid obstacles. These results are widely accepted as suggesting that driving while sleepy should be recognized as potentially dangerous or as at least as dangerous as driving while under the influence of alcohol.
In view of dangers of driving while sleepy or fatigued and an understanding of the effects of obstructive sleep apnea, the Department of Transportation continues to modify requirements for a commercial vehicle driver (or pilot, ship captain or rail operator) to be deemed “Fit for Duty.” The DOT/FMCSA released their Medical Review Board's Recommendations of January 2008, where the Sleep Apnea Guidelines include monitoring drivers for symptoms and potential diagnosis for sleep apnea.
Sleep apnea testing, screening, and monitoring requirements have created an environment where individuals wishing to obtain or keep a commercial drivers license (or any other “fit for duty status”) are fearful of testing positive for sleep apnea, failing to achieve compliant usage, and thus having their license refused or revoked. The fear of losing a job has led some drivers to introduce fraud during ambulatory sleep apnea monitoring. For example, the individual being monitored may switch their oxygen saturation-monitoring device to another person who may be known to present an acceptable oxygen saturation level. The person believed to have acceptable levels wears the device during his or her sleep period, thereby providing a false negative indication for apnea in the desired test subject.
Current methods and designs may become problematic during ambulatory studies when the test individual is not under direct supervision. Ambulatory (e.g., portable), sleep apnea tests can be hours in duration and are typically set up in locations such as, but not limited to, a sleep lab, test subject's home, truck cab, or a hotel. Signals are recorded while the patient is asleep. Prior to or during the testing stage of the oxygen saturation monitoring procedure, the patient being studied may remove the sensing device and give the device to another individual believed to have satisfactory saturation levels. Also, current designs may fail to properly exhibit evidence of tampering when an individual attempts to remove the testing device and associated apparatuses.
With in-patient polysomnography sleep lab supervised tests, fraud may occur by simply having another individual take the desired individual's test by presenting a fake identification such as a non-commercial driving license. Many of today's labs currently operate without checking the patient's identification and presume the person present is the person referred for the test.
Based on the foregoing, it would be beneficial to offer a method for safely and securely conducting an ambulatory sleep apnea test, where the sensing device is secured to the test individual in a tamper resistant or tamper evident manner.